Daniel James Kozubal, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

071003041 Issued in IL

Practice address

412 North Lake St
Ste 203
Aurora, IL 60506

Phone

(630) 244-7000

Fax

(847) 961-5730

NPI assigned

Sep 25, 2006

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Merit-based Incentive Payment System (MIPS)

Final score

91.66 of 100Reported as group

Quality

80.64

Improvement activities

40

Cost

74.35

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Davken Associates, P.C.

  • Clinical Psychologist
  • Deerfield, IL
  • NPI 1457393159
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1328486400000",
    "number": "1215037502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "412 NORTH LAKE ST",
            "address_2": "STE 203",
            "city": "AURORA",
            "state": "IL",
            "postal_code": "60506",
            "telephone_number": "630-244-7000",
            "fax_number": "847-961-5730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "412 NORTH LAKE ST",
            "address_2": "STE 203",
            "city": "AURORA",
            "state": "IL",
            "postal_code": "60506",
            "telephone_number": "630-244-7000",
            "fax_number": "847-961-5730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOZUBAL",
        "first_name": "DANIEL",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-25",
        "last_updated": "2012-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071003041",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "0004572024",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLAN BEH HEALTH",
            "identifier": "054497000",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cathleen Kovanic, AU.D., CCC-A
• Jessica Kowalczyk
• Katelyn Kowalski
• Anita Kozak
• Tiffany Kozlick, FNP-BC
• Megan Kraemer, DO
• Kelly Elise Kramarczyk, M.A., CCC-SLP/L
• Dyzzy Kramer, APN
• Trevor Kramer, B.A., MHP
• Carrie Lynn Kranz, OT

• Clinical Psychologist in Aurora, IL
• Providers in Aurora, IL by specialty
• Clinical Psychologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.